Kellie A Depuydt, NP
Individual provider Active NPI Nurse Practitioner · Laurel, MT
NPI 1801314075 · NPPES record last updated Aug 9, 2023
Key facts
- NPI
- 1801314075
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 127356 (MT)
- Practice address
- 1035 1St Ave
Laurel, MT 59044-2119 - Phone
- (406) 628-6311
- NPI assigned
- Sep 7, 2017
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 7
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- SCL Health Medical Group - Billings LLC
Practice addresses (Care Compare)
32 Wicks LN
Billings, MT 59105-3810
Phone (406) 237-8300
Hospital & facility affiliations
- Intermountain Health St Vincent Regional Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170925002668 | MT | Practitioner - Nurse Practitioner | 4284908518 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 127356 | MT | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Intermountain Medical Group Denver, LLC | Current |
Accepting new patients | |
| SCL Health Medical Group - Billings, LLC | Current |
Accepting new patients | |
| SCL Health Medical Group - Billings LLC | Current |
Accepting new patients | |
| Intermountain Medical Group Denver, LLC | Current |
Accepting new patients | |
| Intermountain Medical Group Denver, LLC | Past | Accepting new patients |
Locations
500 Eldorado Blvd
Ste 4300
Broomfield, CO 80021
8900 E 46th Pl
Denver, CO 80238
Phone (303) 403-6300
8550 W 38th Ave
Ste 320
Wheat Ridge, CO 80033
Phone (801) 442-4122
2019 Broadwater Ave
Billings, MT 59102
Phone (406) 237-5200
32 Wicks Ln
Billings, MT 59105
Phone (406) 237-8300
1027 N 27th St
Billings, MT 59101
Phone (406) 237-5110
1233 N 30th St
Billings, MT 59101
Phone (406) 237-3850
16 N Miles Ave
Hardin, MT 59034
Phone (406) 665-2205
1035 1st Ave
Laurel, MT 59044
Phone (406) 628-6311
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 127356 | MT | Yes |
Addresses
Primary practice location
1035 1St Ave
Laurel, MT 59044-2119
Mailing address
1035 1St Ave
Laurel, MT 59044-2119
Phone (406) 628-6311
Other providers in Laurel, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 9, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.